Brain disease

Question 1

What are the diseases of the brain divided into?

Answer 1

1) Neurological - physical embodiments’/disease of the nervous system (signs and symptoms)
2) Psychiatric - mental disorders (behaviour, perception, feeling etc)

• But research has shown the brain is also abnormal in psychiatric disorders

Question 2

What does neurological assessment of a patient involve?

Answer 2

• Stare of conciousness
• Mental state, attitude, insight
• Cognitive function
• Gait
• Co-ordination and fine movements
• Cranial nerves
• Motor system (power, tone, reflexes, tremor)
• Sensory system (touch, pain, vibration)

Question 3

What does psychiatric assessment of a patient involve?

Answer 3

• Appearance and general behaviour
• Mood
• Speech - disorders of thought
• Insight
• Cognitive state (concentration, confusion, memory)
• Abnormal beliefs (delusions)
• Perceptions (hallucinations)

Question 4

Symptoms of parkinson’s?

Answer 4

• Decrease in spontaneous movements
• Gait difficulty
• Postural instability
• Rigidity and tremor

Question 5

Pathology of parkinson’s?

Answer 5

• Degeneration of substansia nigra

- Resulting in decreased dopamine activity`

Question 6

Incidence of parkinson’s?

Answer 6

• Higher in developed countries

- Frequency increases exponentially with age

Question 7

What is the indirect pathway of the basal ganglia in normal people?

Answer 7

• Inhibitory connections between the striatum and globus pallidus externus and between the sub-thalamic nucleus
• Striatal neurons contain dopaminergic D2 receptors project to the GPe
• STN exerts excitatory influence on the globus palidus internus and substansia pars reticula

Question 8

What is the direct pathway of the basal ganglia in normal people?

Answer 8

• Outflow from striatum directly inhibits the globus palidus internus and substansia pars reticula
• Striatal neurons containing dopaminergic D1 receptors project into the GPi and SNr